Provider Demographics
NPI:1376539023
Name:DUNN, MARIE E (RNC PNP)
Entity Type:Individual
Prefix:MRS
First Name:MARIE
Middle Name:E
Last Name:DUNN
Suffix:
Gender:F
Credentials:RNC PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4887 STATE ROUTE 96A
Mailing Address - Street 2:
Mailing Address - City:ROMULUS
Mailing Address - State:NY
Mailing Address - Zip Code:14541-9767
Mailing Address - Country:US
Mailing Address - Phone:315-585-3054
Mailing Address - Fax:315-585-3061
Practice Address - Street 1:4887 STATE ROUTE 96A
Practice Address - Street 2:
Practice Address - City:ROMULUS
Practice Address - State:NY
Practice Address - Zip Code:14541-9767
Practice Address - Country:US
Practice Address - Phone:315-585-3054
Practice Address - Fax:315-585-3061
Is Sole Proprietor?:No
Enumeration Date:2005-09-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF3816301363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02524981Medicaid